The proposed 36-month study will build on prior research conducted in Cleveland, Ohio. It will examine factors that influence caregiver decisions regarding client trajectories in 100 board and care homes as well as the cognitive and functional health of 100 residents aged 60 years and over of board and care homes in the Baltimore Metropolitan area. The following six research questions will be addressed: 1) How does perceived or anticipated burden of providing care to residents shape caregivers' decisions? 2) How do residents' physical and cognitive limitations reflect the degree of burden perceived by the operator? 3)How do the physical and social environment of the board and care homes enhance or reduce the perceived burden on operators? 4) How do operator characteristics influence the perceived burden of providing service to the board and care residents? 5) How do economic factors influence the decisions made by operators of board and care homes? 6) What resident health and behavior characteristics result in relocation from the board and care environment? The research will proceed through several identifiable stages. First, all non-regulated board and care homes in the metropolitan area will be identified and a random sample of 100 homes will be selected along with a substitution pool (n-20) for replacement purposes. A pre-test stage will involve development and refinement of the research instruments through both ethnographic methods and application of the developed protocols to 10 homes. In the third stage, the interview process will be carried out through four in- depth, face-to-face interviews at six-month intervals and monthly follow-up telephone interviews with operator/caregivers in the board and care homes. At the same time, physical and mental evaluations will be done on 100 residents of the homes, with one resident over the age of 60 randomly selected from each home. As appropriate situations develop, 25 focused ethnographies will be carried out as residents leave board and care homes for other environments. In the final stage of research, the data will be analyzed to answer the research questions.